Gemcitabine and cisplatin chemotherapy in the treatment of platinum-resistant ovarian and peritoneal carcinoma

Abstract

16563 Background: The addition of gemcitabine to platinum-based agents may have synergistic tumoricidal activity. Platinum resistance is related to expression of excision repair proteins and ERCC-1 plays a critical role in the synergy of gemcitabine and cisplatin. Gemcitabine has been shown to be able to reverse cisplatin resistance in previous studies. To evaluated the efficacy and safety of gemcitabine pus cisplatin in recurrent or persistent platinum-resistant ovarian and peritoneal cancer. Methods: Gemcitabine (600 mg/m(2)) was administered intravenously over 30 min followed by cisplatin (30 mg/m(2)) on Days 1 and 8 every 21 days. All eligible patients had measurable disease and at least one prior platinum based regimen. No prior gemcitabine exposure was allowed. Results: Between May 2002 and July 2006. Thirty nine patients were enrolled. Thirty -five were evaluable for response. Seventeen of the patients responded (48.5%, 95% CI 29.0–68.1%). Twelve were partial clinical responses and five were complete clinical responses. The median response duration was 8.9 months. The progression free-interval was 6.7 months (1–15 months). The median survival was 13.2 months.Grade 3/4 neutropenia and thrombocitopenia occurred in 57.8% and 42.3% of patients respectively. Nausea and vomiting grade 3/4 occurred in 36.7% of patients. There was one toxic death (septic shock due to hematologic toxicity-induced infection). Conclusions: Gemcitabine and cisplatin is feasible and active in patients who are platinum resistant and exhibited acceptable toxicity profile. No significant financial relationships to disclose.